Home Birth

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Why have a home birth?

When you find out you’re expecting a baby in the early days at least the last thing on your mind in those first few weeks is thinking about how, when and where you’re going to give birth. You want to ensure that you make it past the 12 week mark, and then the 24 week ‘viable’ milestone.

Often if it is your first pregnancy, or you’ve had a caesarean section you think that home birth is something unattainable by you or a route only ‘earth mothers’ do! Well, it’s not – many pregnant woman can have a home birth if she desires.The important things are to research the subject thoroughly and make sure you’re comfortable with your decision. Make sure that it’s safe for you to give birth at home – in the event of an emergency is it easy for you to transfer to a hospital? Have you got a midwife you can depend on and who can get to you when you need them? Have a birth plan, be relaxed and look forward to giving birth to your child in the comfort of your own home.

Can anyone have a home birth?

In many parts of the country, you won't have any problems arranging a home birth. There are no laws that say that you have to go into hospital to give birth to your baby. The Government has recently announced plans to allow women in England to choose between having their baby in hospital, in a midwife-led unit or at home. However, these plans will not come into effect until 2009 and, at the moment, only one in five women is given the option of a home birth, so you may have to ask for that choice! If your local health care trust isn't supportive, you may have to be very determined about your decision and be assertive in expressing what you want. It is after all your choice to have your baby where you want, and unless there are any medical reasons as to why they may refuse, you are entitled to have a home birth.

Some health professionals are not convinced that home birth is safe although the evidence is clear that it is for most women. You may come up against a GP or a midwife who feels strongly that you should book for a hospital birth. Of course, they may have a very good reason. If you have a history of postnatal haemorrhage or are expecting twins, for example, you would probably be wise to have a hospital birth as there may be complications. On the other hand, if you are advised by a midwife or doctor to go into hospital simply because you are having your first baby, ask them why. There's no evidence that you're putting yourself or your baby at greater risk by opting for a home birth.

How do I organise one?

When you see your GP or midwife after your pregnancy has been confirmed, talk to them about a home birth. If your GP isn't keen, don't worry. You don't need your GP's consent for a home birth. Ask to be referred to a community midwife or to a GP who provides full maternity services. Or write to the manager of your local community midwifery services - get her name and address from your local maternity unit - and say you'd like a home birth. She will then contact you to make the arrangements. Another option is to pay an independent midwife who can carry out your antenatal care, attend the birth of your baby at home if all goes to plan, and provide postnatal care too. Depending on where you live and exactly what services you are going to buy, a home birth with an independent midwife will cost between £1,500 and £4,000.

Can I change my mind?

Yes - at any time. The Government document Changing Childbirth says maternity care providers should "develop a flexible system of care so that women are able to take time in making their decision regarding the place of birth, and can alter that decision close to the time of birth if they so wish". In practice, opting early on for a home birth allows you the greatest possible flexibility, as you can decide to transfer to hospital right up to the delivery itself - possibilities vice versa may be limited due to practical considerations.

What happens if I need to go to hospital in labour?

Your midwife will talk to you and your partner about why she believes a transfer to hospital would be a good idea and will then call an ambulance. This sounds very dramatic, but in fact you're far more likely to need to transfer to hospital because your labour has slowed down than because there's a real emergency. At the hospital, the midwife who has been at your home will still look after you, unless she's too tired to carry on, in which case another midwife will take over your care.

Who will be present at the homebirth?

The community midwife may visit you once, twice, or more during your labour. Once she thinks the birth is imminent, she'll stay with you and will call a colleague to assist during the birth itself. Who else is present is up to you - it's your home, after all.

What equipment do I need?

Very little - a few weeks before your due date, your midwife will bring round a "birth pack" containing all the bits and pieces she needs.

What pain relief is available for a home birth?

Drugs available at home births will vary according to where you live. They include Entonox ('gas and air' - a mixture of Nitrous Oxide, or laughing gas, and Oxygen), and Pethidine, also called Demerol. Your midwife should give you a supply of gas and air when you reach about 37 weeks, but it has been known to run out during home births and emergency supplies have to be couriered in from the local hospital! Your midwife is able to administer Pethidine but please note; Epidurals are not available at home.

What happens after the birth?

Once your baby is born and the placenta (also known as the afterbirth) is safely delivered, the midwives will probably leave you and your partner alone with the baby for a while. They'll then check the baby over and weigh him, help you with your first breastfeed, clear up any mess, and see you into bed. A midwife will always stay at least two hours after the placenta has been delivered, and when she leaves she'll take away any rubbish from the delivery.

Your midwife or another community midwife will then visit you every day for a few days to check the baby over and see how you are progressing. Your GP will also usually call on the first day and carry out a complete check on the baby.

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